PERSONAL NOTE: This issue is obviously very closely to me. My HIV is a preexisting condition any way you slice it and, despite protestations to the contrary, the proposed legislation at a minimum weakens protections for preexisting conditions. I am, of course, pleased that the repeal effort has failed yet again.

Protestor objecting to repeal effort.

This will be a short post. In my inaugural post to this blog, I explained that the then-active effort to repeal the Affordable Care Act could affect the strategy I proposed for HIV+ patients to achieve large savings on health care costs, both for prescription medications and other medical treatment. Well, that effort appears to have died tonight with Sen. Susan Collins issuing a statement opposing the Graham-Cassidy repeal bill. In doing so, she joins her colleagues Sens. Rand Paul of Kentucky and John McCain of Arizona, who have also stated that they will vote no.

Senator Collins’ Statement

Sen. Collins’ issued her statement shortly after a hastily prepared Congressional Budget Office Report concluding that millions would lose their health insurance under the Graham-Cassidy repeal bill. She joins her colleague Sen. McCain in complaining about the Senate Leadership’s handling of the process:

“Today, we find out that there is now a fourth version of the Graham-Cassidy proposal, which is as deeply flawed as the previous iterations. The fact that a new version of this bill was released the very week we are supposed to vote compounds the problem.”

Senator McCain’s Statement

“I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate and amendment. But that has not been the case. Instead, the specter of September 30th budget reconciliation deadline has hung over this entire process. . . . I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried.”

Senator Paul’s Opposition

Sen. Paul has not issued a written statement, but has made clear that he does not support the legislation because it does not go far enough in rolling back the Medicare expansion under Obamacare. That puts him on the opposite side of the issue as his colleague from Maine, who complains in her statement that “1 trillion would be taken out of the Medicaid program between the years 2020 and 2036. This would have a devastating impact to a program that has been on the books for 50 years . . ..” If Sen. Paul issues a written statement, I will update this post.

The Math Does Not Add Up

With only 52 Republican Senators, Republicans could afford to lose only two votes in order to pass the repeal bill on a party line basis that would require the tie breaking vote of Vice President Mike Pence. Republicans now have lost three votes, effectively dooming the legislation. And they may lose a fourth still; Sen. Lisa Murkowski of Alaska has been leaning no, today’s CBO report does not seem likely to sway her to vote “yes.”